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DBA NUCARA PHARMACY #4
CH071410 PEOPLES COMMUNITY HEALTH CLINIC, INC.
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Covered Entity Details
Entity Name
PEOPLES COMMUNITY HEALTH CLINIC, INC.
Subdivision Name
PEOPLES COMMUNITY HEALTH CLINIC
Type
HRSA-Funded Health Center
340B ID
CH071410
Entity Address
905 Franklin St
Waterloo, IA 50703-4407
Grant Number
H80CS00815
Participating Start Date
12/1/1992
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
DBA NUCARA PHARMACY #4
Pharmacy Address
NUDAK VENTURES LLC
209 E SAN MARNAN DR STE 100
WATERLOO, IA 50702-5839
Pharmacy Comments
Contract Details
Approval Date
7/3/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/25/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JENNIFER LIGHTBODY, CEO
(319) 272-4311
Contract Pharmacy Representative
Nudak Ventures LLC
Lori Willis, Acquisitions Manager
(641) 366-3440 Ext: 127
Signed By Date
7/3/2013
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